碳酸司维拉姆片联合醋酸钙胶囊治疗维持性血液透析患者的效果

Effects of Sevelamer carbonate tablets combined with Calcium acetate capsules in treatment of maintenance hemodialysis patients

目的:观察碳酸司维拉姆片联合醋酸钙胶囊治疗维持性血液透析(MHD)患者的效果。方法:选取2020年1月至2022年6月该院收治的100例MHD患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各50例。对照组予以醋酸钙胶囊治疗,观察组在对照组基础上联合碳酸司维拉姆片治疗。比较两组临床疗效,治疗前后血清学指标[血磷、血钙、全段甲状腺激素(iPTH)、碱性磷酸酶(ALP)]水平、肱踝脉搏波传导速度(baPWV),以及不良反应发生率。结果:观察组治疗总有效率为90.00%,高于对照组的70.00%,差异有统计学意义(P<0.05);治疗后,两组血磷、iPTH及ALP水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组血钙水平均高于治疗前,但组间比较,差异无统计学意义(P>0.05);两组baPWV水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:碳酸司维拉姆片联合醋酸钙胶囊应用于MHD患者,可改善血磷、iPTH、ALP水平,降低baPWV水平的效果优于单纯醋酸钙胶囊治疗,且不影响血钙水平。

Objective:To observe effects of Sevelamer carbonate tablets combined with Calcium acetate capsules in treatment of maintenance hemodialysis patients(MHD)patients.Methods:A prospective study was conducted on 100 MHD patients admitted to the hospital from January 2020 to June 2022.According to the random number table method,they were divided into control group and observation group,50 cases in each group.The control group was treated with Calcium acetate capsules,while the observation group was treated with Sevelamer carbonate tablets on the basis of that of the control group.The clinical efficacy,the levels of serological indexes[serum phosphorus,serum calcium,intact thyroid hormone(iPTH),alkaline phosphatase(ALP)],the brachial-ankle pulse wave velocity(baPWV),and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of treatment in the observation group was 90.00%,which was higher than 70.00%in the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of serum phosphorus,iPTH and ALP in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P>0.05).The serum calcium levels of the two groups were higher than those before the treatment,but there was no significant difference between the two groups(P<0.05).The baPWV levels of the two groups were lower than those before the treatment,that in the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Sevelamer carbonate tablets combined with Calcium acetate capsules can improve the serum phosphorus,iPTH,ALP levels and reduce the baPWV levels in the MHD patients.Moreover,it is superior to single Calcium acetate capsules treatment,and does not affect the serum calcium levels.